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Feb. 7, 2025 — In a groundbreaking study published in Nature Medicine, researchers from the University of North Carolina Lineberger Comprehensive Cancer Center have found that electronic reporting of symptoms by cancer patients significantly improves quality of life and reduces emergency department visits.
The national multicenter study revealed that patients with metastatic cancer who regularly reported their symptoms via a home-based electronic monitoring system experienced numerous benefits, including improved well-being and clinical outcomes. However, the overall survival rates between those who used the system and those who did not remained similar.
Study Findings
The PRO-TECT randomized clinical trial was conducted across 52 community oncology practices in 26 states. It involved 1,191 cancer patients, with 593 participants assigned to the patient-reported outcomes (PRO) system and 598 placed in the usual care/control group. Patients in the PRO group had the ability to report symptoms through a web-based program or an automated telephone system.
Key findings from the study include:
- A 6.1% reduction in emergency department visits among PRO users compared to those receiving usual care.
- A 16% longer time before the first emergency visit occurred in the PRO group.
- PRO participants experienced a 31% delay in symptoms deterioration, a 28% improvement in health-related quality of life, and a significant delay in physical function decline compared to the control group.
- Patients overwhelmingly supported the PRO system, with 91% recommending it to others, 84% stating it improved their control over care, and 77% noting enhanced discussions with their healthcare team.
- An impressive 91.5% of patients completed their scheduled weekly symptom surveys.
Expert Insights
Dr. Ethan Basch, lead author of the study and the Richard M. Goldberg Distinguished Professor of Medicine at UNC School of Medicine, emphasized the importance of patient-reported outcomes in bridging communication gaps between doctors and patients.
“Doctors and nurses are often unaware of symptoms and side effects that worsen between office visits, leading to complications and unnecessary suffering,” said Basch. “Our study showed that PRO keeps care teams informed, allowing for timely intervention and improved patient outcomes.”
The PRO system was designed to be managed primarily by nurses and patient navigators, ensuring that patients receive prompt symptom management and care coordination. Importantly, the system was also user-friendly, making it accessible even to patients with limited technical ability.
Implications for Future Research
While the study confirms the benefits of electronic symptom monitoring in metastatic cancer patients, researchers are keen to explore its impact on non-metastatic cases. Sub-study analyses are planned to evaluate results based on patient characteristics such as cancer type, race, and geography. Additionally, interviews with patients, nurses, and doctors will provide further insights into the system’s effectiveness.
“While there have been some studies evaluating the benefits of PRO for patients with earlier-stage cancers, more research is needed to establish its effectiveness in non-metastatic cases,” Basch concluded.
Disclaimer
This article is based on findings from the PRO-TECT study as published in Nature Medicine. While electronic symptom reporting has shown promising benefits, individual patient experiences may vary. Patients should consult their healthcare providers before making any changes to their symptom management practices.
